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Use these checklists to ensure you have met medical documentation requirements based on specific services.
View targeted probe and educate (TPE) round results for ambulance services: basic life support non-emergent transport and mileage (HCPCS A0428 and A0425).
Learn about various programs which focus on ensuring Medicare compliance. Topics include: Comprehensive error rate testing (CERT), prior authorization, and targeted probe and educate.
CMS is implementing a five-year demonstration project for the prior authorization of certain services provided in Ambulatory Surgical Centers (ASCs) and will be implementing the demonstration in two phases.
Read this article for information about how CERT may grant temporary administrative relief to certain affected providers and suppliers during a disaster.
Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.
This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
Top denial/ partial denial reasons and high-level results are listed below from each round of Transitional Care Management (TCM) services TPE reviews that have been conducted thus far by Medical Review.
View these round results for rehabilitation services outpatient.
View targeted probe and educate (TPE) round results for clinical laboratory services.